[abstract] QUALITY IMPROVEMENT IN HYPERBARIC MEDICINE FROM INCIDENT REPORTING

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[abstract] QUALITY IMPROVEMENT IN HYPERBARIC MEDICINE FROM INCIDENT REPORTING

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Title: [abstract] QUALITY IMPROVEMENT IN HYPERBARIC MEDICINE FROM INCIDENT REPORTING
Author: Mueller, PHJ; Heiden, C; Biesinger, E; Hoeing, R; Vavrinek, M; Heiden, M
Abstract: BACKGROUND: Incidence reporting is a widening application in anesthesia and other medical specialties to evaluate medical care quality. Establishing continuous quality assurance (QCI) techniques will lead to better acceptance of Hyperbaric Medicine, now a reluctantly growing specialty in Germany. Introduction of QCI into Hyperbaric Medicine was done worldwide with the Hyperbaric Incident Monitoring Study (HIMS) in 1996 [1] and was introduced in Germany by our Hyperbaric Medicine Institute shortly thereafter [2]. HIMS is now recommended by the German Society of Diving and Hyperbaric Medicine (GTUM e.V.). This is a report about effects of HIMS on delivered medical care in our institutions. METHODS: Reported incidents from a hyperbaric chamber (HAUX Starmed(r) 2200/5.5) of an initial period (baseline) after installation of the study (1 Jun. 96 - 31 Aug. 96) were compared to incident reports from a similar period (1 Sep. 96 - 30 Nov. 96) by retrospective analysis. Total of patients and hyperbaric exposures from compared periods were evaluated. RESULTS: Totally 39 incidents were reported. Baseline was 21 reports vs. 18 in the comparison period. Patient complications were found in 16 vs. 12 reports, staff complications in 1 vs. 2 cases and incidents involving the chamber, control and monitoring system were 4 vs. 4 reports. Patient complications originated from barotrauma (ear: 14 vs. 6, sinus: 1 vs. 1, pulmonary: 0 vs. 1), claustrophobic reactions (1 vs. 3) and cerebral oxygen toxicity (0 vs. 1). A marked reduction (57.2percent) in the leading patient complication middle-ear barotrauma is evident, while other complications remain unchanged. The latter seem to be system-immanent, while corrective strategies can reduce patient morbidity. CONCLUSION: Results show beneficial effects from incident reporting in clinical hyperbaric practice. Furthermore potential hazards may become evident before patients or staff are endangered. HIMS therefore provides a useful tool to ascertain patient and staff safety and improves quality of delivered care in Hyperbaric Medicine. REFERENCES: [1] Pirone CJ, Williamson JA: The hyperbaric incident monitoring study (HIMS): an anonymous incident reporting system that depicts patient and staff safety problems in hyperbaric clinical practice (Abstract). Undersea and Hyperbaric Medicine, Vol. 23, 1995 Suppl., A 137. [2] Mueller PHJ, Brinninger I, Vavrinek M., Heiden M: Hyperbaric Incident Monitoring Study (HIMS): Introduction and preliminary results. Program and Abstracts, 7. GTUM e.V. Symposium on Diving and Hyperbaric Medicine, 27-29 Sept., 1996, Hofheim/Germany.
Description: Undersea and Hyperbaric Medical Society, Inc. (http://www.uhms.org )
URI: http://archive.rubicon-foundation.org/403
Date: 1997

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  • UHMS Meeting Abstracts
    This is a collection of the published abstracts from the Undersea and Hyperbaric Medical Society (UHMS) annual meetings.

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